Liossi C, Noble G, Franck L S
University of Southampton, UK; Great Ormond Street Hospital for Children, London, UK; UCL Institute of Child Health, London, UK.
Eur J Pain. 2012 Sep;16(8):1166-75. doi: 10.1002/j.1532-2149.2012.00111.x.
Little is known about the communication of everyday pain between young children and their parents, i.e. when children experience pain resulting from minor injury or illness that occur in everyday life. This study aimed to gain an in-depth understanding of how parents make sense of their young children's expression of everyday pains and how they respond.
Parents (n = 48) of children (1-5 years inclusive) participated in focus group discussions at seven children's centres across England where they were asked to describe their children's communication of everyday pain. Thematic analysis was used to analyse the data.
Six main themes were identified in the parents' discourse. Parents described children's pain communication as (1) sharing common elements, but unique to each child; (2) having multifaceted pain and non-pain-related purposes; (3) challenging to interpret; (4) influenced by their own pain-related communication; (5) requiring a variety of pharmacological, psychological and physical strategies to manage. The sixth theme that emerged from the data related to parents' dissatisfaction with health care providers, particularly general practitioners' sometimes quick dismissal of parental concerns about their children's pain and illness complaints.
These findings suggest that parents have well developed, although personal, ways of recognizing and responding to their children's communication of pain, but also experience uncertainty in their judgments. Parents would benefit from information about the developmental aspects of pain and should be included as active partners in their children's pain assessment and management.
对于幼儿与其父母之间日常疼痛的交流,即当孩子经历日常生活中因轻伤或疾病引起的疼痛时,我们知之甚少。本研究旨在深入了解父母如何理解幼儿日常疼痛的表达以及他们如何做出反应。
英格兰七个儿童中心的48名儿童(年龄在1至5岁之间)的父母参加了焦点小组讨论,在讨论中他们被要求描述孩子日常疼痛的交流情况。采用主题分析法对数据进行分析。
在父母的话语中确定了六个主要主题。父母将孩子的疼痛交流描述为:(1)具有共同要素,但每个孩子又各有独特之处;(2)具有多方面与疼痛及非疼痛相关的目的;(3)难以解读;(4)受他们自己与疼痛相关的交流影响;(5)需要多种药物、心理和身体策略来应对。数据中出现的第六个主题与父母对医疗服务提供者的不满有关,特别是全科医生有时会迅速驳回父母对孩子疼痛和疾病投诉的担忧。
这些发现表明,父母虽然有个人化的方式,但已经能够很好地识别和回应孩子的疼痛交流,但在判断时也会感到不确定。父母将受益于有关疼痛发展方面的信息,并且应该作为积极的合作伙伴参与到孩子的疼痛评估和管理中。